Victorian London - Health and Hygiene - Hospitals - St. Bartholomew's Hospital

St. Bartholomew's Hospital, in Smithfield, is a magnificent structure of atone, consisting of four piles of building that surround an open court. This vast establishment, capable of containing 500 beds, has, in the course of one year only, afforded relief to above 1000 patients.

Mogg's New Picture of London and Visitor's Guide to it Sights, 1844

BARTHOLOMEW'S (ST.) HOSPITAL, the earliest institution of the kind in London, was part of the priory of St. Bartholomew, founded A.D. 1102. by Rahere, the first prior. He designed it "Ad omnes pauperes infirmos ad idem hospitale confluentes quosque de infirmatibus suis convaluerint, ac mulieres praegnantes quosque de puerperio surrexerint, necnon ad omnes pueros de eisdem mulieribus intra hospitale praedictum decesserint." [see St. Bartholomew the Great] The executors of Richard Whittington, the celebrated Mayor, repaired Hospital about the year 1423, and at the dissolution of religious houses, Henry VIII, at the petition of Sir Richard Gresham, Lord Mayor and father of Sir Thomas Gresham, founded it anew as an Hospital "for the continual relief and help of an hundred sore and distressed," being "moved thereto with great pity for and towards the relief and succour and help of the poor, aged, sick, low, and impotent people ... lying and going about begging in the common streets of the city of London, and the suburbs of the same," and "infected with divers great and horrible sicknessses and diseases." The immediate superintendence of the Hospital was committed at first to Thomas Vicary, Serjeant-Surgeon to Henry VIII, Edward VI, Mary, and Elizabeth, and author of The Englishman's Treasure, the first work on anatomy published in the English language. Harvey, the discoverer of the circulation of the blood, was Physician to the Hospital for thirty-four years, (1609-1643), and the rules which he laid down for the duties of medical officers of the Hospital were adhered to for nearly a century after his retirement. * (*Records of Harvey; in extracts from the Journals of the Royal Hospital of St. Bartholomew With notes by James Paget. 8vo. 1846) The date of the actual commencement of a Medical School is unknown; but in 1662, students were in the habit of attending the medical and surgical practice; and, in 1667, their studies were assisted by the formation of a Library "for the use of the Governors and young University scholars." A building for a Museum of Anatomical and Chirurgical Preparations was provided in 1724, and placed under the Surgeon to the Hospital; and, in 1734, leave was granted for any of Surgeons, or Assistant-Surgeons, "to read Lectures in Anatomy in the dissecting-room of the Hospital." The first Surgeon who availed himself of this permission was Mr. Edward Nourse, whose anatomical lectures, delivered for many years or near the Hospital, were followed, in 1765, and for many years after, by courses of Lectures on Surgery from his former pupil and prosector, Perceval Pott; and about the same time, Dr. William Pitcairn, and subsequently Dr. Daivd Pitcairn, successively Physicians to the Hospital, delivered lectures, probably occasional ones, on Medicine. Further additions to the course of instruction were made by Mr. Abernethy, who was elected Assistant-Surgeon in 1787, and by whom, with the assistance of Drs. William and David Pitcairn, the principal lectures of the present day were established. Abernethy lectured on Anatomy, Physiology and Surgery, in a theatre erected for him by the Governors in 1791, and his high reputation attracting so great a body of students it was found necessary, in 1822, to erect a new and larger Anatomical Theatre. The progress of science and the extension of medical education in the last twenty years have led to the institution of additional lectureships on the subjects auxiliary to Medicine, and on new and important applications of it; and further facilities have been afforded for instruction. In 1835, the Anatomical Museum was considerably enlarged, a new Medical Theatre was built, and Museums of Materia Medica and Botany were founded; and at the same time, the Library was removed to the present building, and enriched by liberal contributions. In 1834, the Medical Officers and Lecturers commenced the practice of offering Prizes and Honorary Distinctions for superior knowledge displayed at the annual examinations of their classes; and in 1845, four scholarships were founded, each tenable for three years, and of the annual value of 45l. and 50l., with the design not only of encouraging learning, but of assisting Students to prolong their attendance beyond the usual period, on the medical and surgical practice of the Hospital. In 1843, the Governors founded a Collegiate Establishment, to afford the Pupils the moral advantages, together with the comfort and convenience, of a residence with the walls of the Hospital, and to supply them with ready guidance and assistance in their studies. The chief officer of the College is called the Warden. The President of the Hospital must have served the office of Lord Mayor. The qualification of a Governor is a donation of 100 guineas. The great quadrangle was built by James Gibbs, the architect of St. Martin's-in-the-Fields, and the first stone laid June 9th 1730. The gate towards Smithfield was built in 1702, and the New Surgery in 1842. This Hospital gives relief to all poor persons suffering from accident or diseases, either as in-patients or out-patients. Cases of all kinds are received into the Hospital, including diseases of the eyes, distortions of the limbs, and all other infirmities which can be relieved by medicine or surgery. Accidents, or cases of urgent disease, may be brought without any letter of recommendation or other formality at all hours of the day or night to the Surgery, where there is a person in constant attendance, and the aid of the Resident Medical Officers can be instantly obtained. General admission-day, Thursday at 11 o'clock. Petitions for admission to be obtained at the Steward's Office, any day, between 10 and 2. Any other information may be obtained from the porter at the gate. The Hospital contains 580 beds, and relief is afforded to 70,000 patients annually. The in-patients are visited daily by the Physicians and Surgeonsl; and during the summer session, four Clinical Lectures are delivered weekly. The out-patients are attended daily by the Assistant-Physicians and Assistant-Surgeons. Students can reside within the Hospital walls, subject to the rules of the Collegiate system, established under the direction of the Treasurer and a Committee of Governors of the Hospital. Some of the teachers and other gentlemen connected with the Hospital also receive Students to reside with them. Further information may be obtained from the Medical or Surgical Officers or Lecturers, or at the Anatomical Museum or Library. The greatest individual benefactor to the Hospital was the celebrated Dr. Radcliffe, who left the yearly sum of 500l. for ever, towards mending the diet of the Hospital, and the further sum of 100l. for ever, for the purchase of linen. Observe.- Portrait of Henry VIII. in the Court Room, esteemed an original, though not by Holbein; Portrait of Dr. Radcliffe, by Kneller; good Portrait of Perceval Pott, by Sir Joshua Reynolds; fine portrait of Abernethy, by Sir T. Lawrence. The Good Samaritan, and The Pool of Bethesda, on the grand staircase, were painted gratuitously by Hogarth, for which he was made a governor for life; the subjects are surrounded with scroll-work, painted at Hogarth's expense by Mr. Richards.

Peter Cunningham, Hand-Book of London, 1850

see also William Acton in Prostitution - click here

ST. BARTHOLOMEW'S, West Smithfield, founded by Rahere, in 1102, enlarged by Whittington, and incorporated in the reign of Henry VIII., in 1546, is a handsome and capacious edifice of stone, after the designs of Gibbs, surrounding a square, and situated between Christ's Hospital and Smithfield, on the site of the ancient priory of St. Bartholomew. The principal entrance (erected in 1702), in Smithfield, is through a large arch in a rustic basement, over which is placed a bust of Henry VIII. Above is an interrupted semi-circular pediment, on whose segments recline two figures emblematical of lameness and sickness, The whole surmounted by a triangular pediment, whose tympanum is ornamented with the royal arms. Any persons suffering from serious accidents or illness are admitted into this hospital at any hour of the day or night, without previous recommendation. The interior arrangements are convenient and ample; the professional attendance is able, well divided, and abundant; the nurses and attendants are kind, humane, and numerous; and the greatest order and propriety reign throughout the whole. This institution affords an excellent practical school of medicine and surgery for young men who "walk the hospitals." There is also a "theatre," where lectures are delivered to the students by eminent practitioners.
    The grand staircase was painted gratuitously by Hogarth; the subjects very appropriate: The Good Samaritan; the Pool of Bethesda; Rahere (the founder) laying the First Stone; and a Sick Man carried on a Bier attended by Monks. In the great hall is a portrait of Henry VIII., and another of Dr. Radcliffe, who left 600l. per annum towards improving the diet and linen of the patients. Here is also a picture of St. Bartholomew, with the symbol of his martyrdom in his hand. One of the windows is illustrated by the representation of Henry VIII. delivering the charter to the Lord Mayor. The expenses of this hospital are nearly 35,000l. per year. The number of in-patients received last year was nearly 6000, and out.-patients upwards of 105,000. In the reign of Henry VIII. the hospital expenditure was 800l. yearly; in 1660 it had increased to 2000l.; and in 1730 to 10,000l. There are now 22 wards, each with 20 beds ; but 640 in-patients can be conveniently accommodated. Abernathy and the great Harvey have been among the physicians and surgeons who have laboured at St. Bartholomew's.

Cruchley's London in 1865 : A Handbook for Strangers, 1865

Victorian London - Publications - Social Investigation/Journalism - Unsentimental Journeys; or Byways of the Modern Babylon, by James Greenwood, 1867

   PREFACE.

   CROPPING up in the book-field, modest and unpretending as any sprig of sorrel or chickweed that ever sprouted, this book at least claims an advantage over other books in the matter of Preface.
   Commonly, a Preface is like a finger-post set up in a toll-road, on which you first pay for the privilege of travelling, and then are allowed to judge for yourself whether the way indicated will suit you, or whether it will be more profitable to turn back, forfeiting the money you paid at the gate, and striking into another path in search of "pastures new." The advantage alluded to as attaching to this book, consists in the fact that its preface is fully contained in the title imprinted on the back of it. There is no more to be said about it. It is simply a collection of personal observation of experience yielded in the course of two-score or so of as unsentimental journeys as ever were undertaken by the most ordinary tramp. The collection is the result, not of a labour of love purely-although, of course, a liking for the subject was the prime inducement for entering on its investigation,-but of down-right, jog-trot journey-work.
   The reader who regards elegance of style in an author as the first essential is respectfully warned that herein it is wanting-so completely, in fact, that it is scarcely worth while to mention it; it would have been discovered as quickly. If, however, the indulgent reader will deign to accept scrupulous honesty and plain, outspoken truth in lieu of varnish and elaboration, he may depend on fair dealing at the hands of his obedient servant,
   THE AUTHOR.
    
I. THE HOSPITAL-GATE.

   THE notice-board at the gate notifies to all who may have come into that inheritance to which we have Shakspeare's authority for declaring all flesh has title, that the proper time to attend to be mulct as far as may be of the said inheritance is between the hours of eleven and one o'clock daily. Therefore, as the hospital clock chimed the former time, I struck out of Giltspur Street, and approached the sombre building; not, my lucky stars be thanked, as one needing aid of surgeon or apothecary, but to see one of the most melancholy and instructive pictures to be met in London's length and breadth. Being an intruder, and not disposed to flaunt my healthfulness to the dull and sorrowing gaze of those who clustered at the portal, I took my station in the shadowy lee of a fragrant hay waggon, and, sitting down on the deserted shaft of it, secured a fair view of up the street and down the street, and across the road.
   I experienced little difficulty in distinguishing from among the pedestrians who thronged the pavement they who had business with Saint Bartholomew; for the notice- board, among other things, particularly stipulated that "patients must provide themselves with gallipots and bottles ;" and, as a rule, the pale ones, and the lame ones, and they who were led because they could not see, were so provided. Gracious me! what a leveller of pride is Death's lieutenant, Sickness ! Here comes Jones, worthy man, meekly bearing his gallipot, wrapped in paper, it istrue, but palpably a gallipot, whereas, if he were unafflicted and free to perform as usual the diurnal journey out and home from Islington to the City, he would go dinnerless rather than be the bearer of his own mutton chop. Likewise comes estimable Mr. Robinson, who, before his system was shocked beyond the pomps and vanities of this wicked world, disdained to carry so vulgar an article as a gingham umbrella (perhaps that is how he caught his rheumatism, poor man), now exhibits, peeping from the tail-pocket of his coat, the throat of the quart bottle that is to contain his "mixture."
   The respectable Browns or Joneses, however, are scarcely fair samples of the patrons of Saint Bartholomew: if their ailments are not very severe, their "regular" doctor will set them right for a pound or so, and they can afford to pay it, Neither is the wan army recruited specially from the squalid, loud-mouthed poverty of the City; it is the latter! that obstructs the doorway and invades the narrow limits of the "parish" surgery, for the most cogent reason that bread and meat may be included in the parochial M.D.'s prescriptions, and lazy father's bad foot, or sister Polly's asthma be thus made a source of income rather than of impoverishment to the entire family. It is chiefly those whom no amount of hunger would induce to beg a loaf that demand hospital relief; who would go empty and thinly clad, and no more dream of applying at a workhouse for alms than they would dream of assuaging their distress by a larcenous onslaught on their neighbours' goods. The horny-handed ones are these, and the horny-handed ones' wives, who while they can work will, and at whose door, while health holds good, "the wolf," or its shadow even, is unknown. It is sickness alone that gives the grim beast ingress; and there he is allowed to stay, roaming about the house, and ravaging it, plucking the treasured silk gown from its sacred hiding, the hard-earned watch from the fob, the Sunday suit from the clothes - chest, the well-worn wedding-ring even from the lean finger; and the number of the house where the wolf is sojourning being 31, neither 30 nor 32 have the least suspicion of the fact. Nobody is aware of it; least of all any gentleman in the neighbourhood whose business it is to vend advice and healing drugs at a profit. Not a penny of the wolf's plunderings goes to him. Why should it ? The healing skill to be found at the hospital is of a higher order than can be bought for a little money, and there is no taint of pauperism in partaking of the advantage. The hospital is public property-as proper a place for a man to visit for relief for his malady as the British Museum or the National Gallery for amusement and instruction, or the common to play cricket on. So argue the honest endurers of the wolf at number 31, and, without doubt, they are perfectly correct.
   Whilst, however, I sit philosophising on the waggon- shaft the human cluster at the gate has grown thicker. Along the broad steps sit mothers cuddling to their bosoms sick infants, varying in age from the tiny creature ignorant of a want beyond to the languid little fellow of four or five whom affliction has once more reduced to babyhood. Why the mothers sit here I do not know. Perhaps the gentleman appointed to the sick-baby department has not yet arrived, or, having arrived, is so besieged with mothers that these considerate ones prefer sitting in the sun with their darlings till the press has abated and they can take them in without disturbance. Perhaps, again, having so nearly reached the terrible place where for their health's sake the poor little sufferers must be put to pain, mother's tender heart fails her, and she is obliged to sit thus on the threshold to consider her little one's long- suffering, and to contemplate its wasting face, to screw her courage for the final effort.
   No wonder if it is so, since from my post of observation I can see grown men and women, and tall young men and maidens, guilty of the same weakness. I am quite convinced that the pulling of teeth is not the most painful operation to which a hospital patient may be subjected; and yet, of all who " hang on and off," as the nautical phrase is, loitering among the deserted cattle-pens, and looking wistfully and alternately at the grim building and at the road that tends homeward, the ones with bandaged jaws numbered most. Of course their case is veryhard (having had in my time two grinders extracted whose decay in no way shook their attachment to me; I know how hard their case is); but what amount of pity could be spared for them in presence of the terrible things that everywhere met the eye ? The pains as well as the pleasures of the world can only be measured by comparison. By the side of a shattered limb toothache becomes a mere trifle; and, compared with many of the appalling spectacles to be met within a circuit of a hundred yards of Old Bartholomew any day between the hours of eleven and two, it becomes less than a trifle-a joke, and a thing to be laughed at.
   Why, within the limit mentioned, I can see a dozen men who, if the transfer were possible, would accept the most villainous tooth that ever a mouth was troubled with in exchange for their ailment, and throw in as a bonus a good year of their lives, chancing how long they would live without it. Not the worst-looking cases either, some of these. Take, for example, that elderly man with his arm slung to his neck, and accompanied by his two sons, as pale and as anxious as himself. How wretchedly cheerful the trio are ! How the eldest of the old fellow's boys, winking sternly at the younger to be sure and countenance the dreadful fib he is about to relate, launches into the particulars of a "case "-a terrible case, compared with which father's is the merest cat-scratch-in which, thanks to the blessed application of chloroform, the limb was shorn, the patient dreaming the pleasantest dreams the while! And the good old boy, to comfort the young ones, affects the most perfect belief in the story, and even essays a ghastly little joke on the subject, while all the time his heart is at freezing-point through thinking that if the amputation of those blessed fingers should cost him his life, what a woful thing it will be for Polly (his wife) and the three little ones. But there is no help for it; he will surely die unless he submits to the terrible ordeal; so, just a tiny nip of brandy to keep his courage up, and in he goes, the boys looking after him almost as people look when the undertaker's man, twiddling his screwdriver, observes, with professional melancholy, "Would any other member of the family like," &c. "Room there, you about the gate! Ring the bell, boy, will you?" Not the least occasion. The liveried porter, hearing the hasty wheels, has just peeped out to see a cab, with a policeman descending from the driving- seat, and the next moment makes his appearance with a companion, the two carrying a "stretcher." "Slater off a roof!" exclaims the policeman, shortly; and, gently handled by a dozen willing hands, as though he were a baby, the pallid man, with his great, dirty, labouring hands, and the slating-nails dropping from his jacket- pocket and tinkling on the pavement, is borne through the gate to have his shattered bones set and be brought to life again, if the ripest skill in the kingdom can accomplish the doubtful business.
   One thing is certain. The shattered slater will not pine to death in his ward from lack of company. No trade is better represented in the accident ward than that of house-building. If I was in the life-assurance line I think I would almost as soon lease the life of a soldier as of a house-painter, a bricklayers' labourer, or a slater. I think I would quite as soon do it, and I do not believe I should be out of pocket by it. In his battle for bread the latter risks his life equally with the former, who fights his country's battles. Where is the difference ? One man in the ranks with his comrades may catch a bullet in his carcass; the other, sprawling on a slippery slant, with a clear descent of forty feet to the street stones, is at the mercy of a rotten rope or a sudden wind. The soldier, sword in hand, pitted against another soldier, fights for his life; the house-painter, a-top of a fifty-round ladder, may at any minute of his working days be seized with a vertigo, or the first drunken booby that comes up the street may stumble against the ladder's foot, and the poor painter in an instant make a swift descent to certain death. In one respect the soldier has the advantage; for whereas at least half his life is spent in consuming his rations, pipeclaying his leathers, and washing his shirts, the poor slater begins his battles with his apprenticeship, and continues them till he becomes too old and decrepit to mount a ladder.
   It is wonderful how one grows used to horrors. Shortly after the commotion (very slight it was) consequent on the slater's arrival had subsided, there came in succession two " run-overs" and an Irish person severely wounded on the head with a drinking-vessel. I was enabled, however, to regard the ugly scene with perfect equanimity, and even cast about me for something more interesting. I didn't look in vain. At some distance from the casual gate there is another, and about this was a group expectant, evidently, from the way in which, every few seconds, they peered up the archway in which a beadle kept sentry. I was too far off to hear what they said, but presently one, who happened to be watching at a moment when no one else was, made a sudden observation, and then the whole party eagerly turned and looked too, and it was easy enough to see, by the way in which all the lips moved, that " Here he comes ! "was uttered by them all.
   Who was "he"? A tall young fellow, with lanky legs, very thin, and with a delicate, newly-made-looking face. These were his most remarkable points, as far as I could judge; but the watchers at the gate saw more than this plainly, or they would never have made such a fuss with him. He didn't come out alone. There was with him a little elderly woman, who held his hand in hers, as though afraid of losing him the moment they reached the corner of the street; while, at the same time, one was made aware, by the little woman's bright, brimming eyes, that a more cruel thing could scarcely happen. No sooner, however, did the odd pair approach the group than a man with grey hair and spectacles, and a little taller than the little woman, seized the lank young man by the disengaged hand, and for a moment seemed inclined to wrestle with the old lady for possession of the prize. This, however, the old lady appeared to object to, not unkindly, however, for she first shook hands with the old fellow in a queer sort of way, and then, turning broadside on to the slender young man, clutched at his neck, and, pulling his face down to hers (he seemed very supple, poor fellow!) kissed him, till he with the spectacles exclaimed in an ashamed voice, and quite loud enough for me to hear, "Come, mother, that'll do-in the street, you know!
   If it had not have happened that the way of the curious party lay in the direction of my hay-waggon, I might have been puzzled till my dying day to know what it all meant. I was, however, spared that infliction, for just as they were trooping past I heard the little grey-haired man say,-
   "I'm bothered if it isn't, mother ! A year and two months come the 23rd, and he has grown a foot if a single inch!" The year and two months must have been the time the young fellow had lain at Old Bartholomew's. Victorian London - Publications - History - The Queen's London : a Pictorial and Descriptive Record of the Streets, Buildings, Parks and Scenery of the Great Metropolis, 1896 - The Quadrangle, St. Bartholomew's Hospital

The Quadrangle, St. Bartholomew's Hospital - photograph

THE QUADRANGLE, ST. BARTHOLOMEW'S HOSPITAL.

 Although the great Quadrangle of St. Bartholomew's Hospital, Smithfield, only dates from 1730 Gibbs being the architect, the Hospital itself is the oldest in London. The founder was Rahere, minstrel to Henry I , and first prior of St. Bartholomew's, of which the Hospital formed part. "Dick" Whittington, Lord Mayor of London, enlarged the place, which was re-established by Henry VIII. ten years after the suppression of the monasteries. The income of "Bart's," as the Hospital is commonly called, is 50,000 a rear, and in the course of twelve months some 7,000 in-patients, who as they become convalescent take the air in the pleasant open space shown in out picture, receive treatment, besides nearly 180,000 out patients. Harvey and Abernethy are among the famous men who hare been connected with this Hospital.

Victorian London - Publications - History - The Queen's London : a Pictorial and Descriptive Record of the Streets, Buildings, Parks and Scenery of the Great Metropolis, 1896 - St. Bartholomew's Hospital : The West Entrance

St. Bartholomews Hospital : West Entrance - photograph

ST. BARTHOLOMEW'S HOSPITAL: THE WEST ENTRANCE.

The western gate of St. Bartholomew's Hospital looks out upon the stone-paved, noisy neighbourhood of the London Central Meat Market. Over the gate, which was built in 1702, is a statue of Henry VIII., who was induced to re-establish the institution when the monasteries were suppressed; and the semi-recumbent figures represent respectively a sick man and a cripple. The church behind the gate is St. Bartholomew's-the-Less, founded, with the Hospital itself, by Rahere early in the twelfth century, but rebuilt in 1823. The tower of the much more interesting church of St. Bartholomew-the-Great rises to the left of our picture, beyond the circular road leading beneath the market. The building to the left of the gate is the casualty and out-patients' department of the Hospital.